Essays on clinical decision making

Authors attempting to describe JDM do so using many constructs and expressions refereeing to the same phenomenon.

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JDM is referred to as in literature as inferences, judgement, diagnostic and clinical reasoning. In the clinical setting, JDM is viewed as a professional choice to a task: a practice carried put in real-life not activity imagination by persons perceiving professional status to be good in its right instead of being a means to achieve desirable higher qualities of patient care Tanner Then, judgment entails the professional assessment of alternatives leading to the making of choice; in this sense, the future is also assessed Dowie Essay: Clinical Judgement and Decision Making 3 field experts and from research evidence Shaban Then, the progression of qualitative judgements raises issues of subjectivity and objectivity.

It is in this sense that a realisation is made on how the notions of uncertainty are an underestimated component of the JDM processes, more so in contexts with heightened stresses Hammond Clinical decision making was initially defined by Benner, Tanner, and Chelsa as…. Clinical decision-making is a complex and continuous process that includes dynamic interacting elements and critical thinking. This process involves both intuitive and analytic cognitive modes, which is defined in term of dual-process theory.

The Process of Decision Making in Nursing Essay Example

It is an automatic response, low awareness less effort so it can be prone to error in decision making…. This proposal will present a technical solution, using case based reasoning, to help prevent the occurrence of errors, thus reduce adverse events, and to make suggestions to the line staff as to what to do when such an event or error happens. Purpose and Goals One of many nationwide initiatives to help reduce the occurrence of unnecessary medical errors and adverse events is the use of the integrated Clinical Decision Support System CDSS.

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  5. A CDSS is a system that provides the right information…. It also elaborates on the postoperative pain management process of Josie guided by Tanners model of clinical judgement.

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    It is common to experience pain by the patient after the surgery. Post-operative pain is the form of acute pain which is obvious but unwanted experience after the surgery. Effective postoperative pain management is a crucial element…. The nurse would have recognised, responded and correctly followed the protocols by communicating with the multidisciplinary team immediately without delay. For this reason, any complaints that falls under unsatisfactory conduct or…. Effective clinical reasoning skills are essential in nursing; an estimated half of all clinical adverse events are attributed to errors in clinical decision-making Levett-Jones et al.

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    Unfortunately, there are barriers impeding the progress of this important role. As stated by Avolio and Williams , these barriers include budget constraints, geographical inconsistencies regarding an understanding and experience of the role, and the lack of dedication. Williams, Wolf, and Spada , confirm the contributing barrier to implementing the CNL as a general lack of knowledge about and the exposure of the CNL. The general consensus of the deficient understanding regarding the CNL between the two groups of authors is what I feel is a major barrier.

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    Subsequently, this then leads to a lack of exposure of the CNL nationally. Higher education and advanced practice allows us to have a positive influence on patient outcomes, creating better prognoses and lowering readmission rates. This is made possible because facilities that have been exposed to the CNL role understand the importance.


    Barriers, when understood and identified, can be addressed in a strategic fashion. This is not done so in a manner that is manipulative or deceptive, but to be shown how the barrier is in actuality, hurting the institution. For example, if a facility is grounded in the belief of an existing system in play is the best manner in which to treat patients, those who have good intentions can strategically clarify how their program, in this case the CNL role, may help strengthen the facilitates cause.

    There are many outpatient heart clinics with patients who suffer from congestive heart failure. These facilities typically have high readmission rates related to poor patient outcomes.

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    A prime example regarding poor patient outcomes as described by Smith , as once the CNL role was introduced to heart failure HF inpatient program, the program under question experienced a huge reduction in readmission rates. The advantages of exposure to the CNL role had ultimately positively affected patient outcomes. Monaghan, expresses the success experienced by the VHA regarding patient safety. It is widely understood regarding VHA and its patients are not necessarily going to improve upon their conditions.

    Yet, the emphasis on preserving the quality of life is quite strong, which is why the VHA have not only embraced the CNL, but has publicly pledged to become the driving force in implementing the CNL in each facility by The VHA has reported a reduction in falls, nosocomial infections, pressure ulcers, and has created a patient nurse relationship in which nurses are able to spend more hours with their patients each day.

    Subsequently, a positive correlation can be demonstrated as an increase in time spent with patients positively affects compliance regarding medication.

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